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5 k L tC I: In Sunday <br />E'M -P L0YME NT SE RV I:(ES <br />P.O. Box 71250;• Eugene, OR 97401 Monday <br />PLEASE PRINT <br />PLOYEE NAME Tuesday <br />SELEGEMP <br />E MP'L0YMENT SERVI C'ES <br />P.O. Box 71250 • Eugene, OR 97401 r <br />PLEASE PRINT <br />EMPLOYEE NAME <br />SOCIAL SECURITY NUMBER <br />COMPANY NAME <br />i <br />WEEK ENDING DATE <br />❑ ASSIGNMENT COMPLETED ❑ RETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK ?' <br />❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. <br />D NO <br />Thursday I�--'� <br />CG <br />Friday L�39 <br />Saturday <br />l i <br />SSE. ? <br />f) <br />co ' z. 7.5 <br />I <br />, <br />Hours to nearest quarter hour. <br />~ CUSTOMER <br />',REG HOURS:. " OS HOURS <br />'+R <br />EMPLOYEE ; <br />I cast, that the hours ithown represent my total h ms walled during the <br />week and that they were properly by the client dr try an authorized` <br />representative. Also any work related Injures were reported to Selectemp <br />at the time of injury. Sea reverse for further information.' - <br />d <br />PY <br />- SECURITY NUMBER <br />COMPANY NAME <br />i_ <br />r <br />i V'l . G- <br />. 4 {.eoc . <br />JOBSiTE NAME AND /OR PO# ' <br />REG <br />HOURS <br />7 <br />ING DATE <br />Q <br />❑ ASSIGNMENT COMPLETED RETURNING N.eXT.WEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? <br />❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY,; <br />0 NO <br />SELEGEMP <br />E MP'L0YMENT SERVI C'ES <br />P.O. Box 71250 • Eugene, OR 97401 r <br />PLEASE PRINT <br />EMPLOYEE NAME <br />SOCIAL SECURITY NUMBER <br />COMPANY NAME <br />i <br />WEEK ENDING DATE <br />❑ ASSIGNMENT COMPLETED ❑ RETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK ?' <br />❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. <br />D NO <br />Thursday I�--'� <br />CG <br />Friday L�39 <br />Saturday <br />l i <br />SSE. ? <br />f) <br />co ' z. 7.5 <br />I <br />, <br />Hours to nearest quarter hour. <br />~ CUSTOMER <br />',REG HOURS:. " OS HOURS <br />'+R <br />EMPLOYEE ; <br />I cast, that the hours ithown represent my total h ms walled during the <br />week and that they were properly by the client dr try an authorized` <br />representative. Also any work related Injures were reported to Selectemp <br />at the time of injury. Sea reverse for further information.' - <br />d <br />PY <br />SELEGEMP I S unday <br />EMPL0YMENT' SERYI CES Rk_:. <br />P.O. Box 71250 • Eugene, OR 97401 Monday <br />PLEASE PRINT <br />_ + EMPLOYEE NAME <br />N rI_ <br />SOCIAL SECURITY NUMBER <br />J5 <br />COMPANY NAME <br />�. C [ L- 1C(4IL <br />WEEK.ENDING'DATE <br />❑ ASSIGNMENT COMPLETED Q RETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? <br />❑ YES IF YES, NOTIFY - SELECTEMP IMMEDIATELY. <br />'NO <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />CUSTOMER COPY <br />START <br />i ' <br />STAR <br />SroP <br />LESS <br />LUNCH.. <br />REG <br />HOURS <br />OVERTIME <br />HOURS, <br />FOR OFFICE USE ONLY <br />REG. HOURS <br />OT HOUR S ' - <br />. l oo <br />J c a <br />FHOU <br />Sunday <br />i7. <br />Monday <br />i <br />t <br />Tuesday <br />EMPLOYEE. <br />- I ced fy that the hours shown represent my total hours worked during the <br />weak, and that they were properly verified by the client or try an authorized <br />®presentative: Also, any work related mlunee were reported to Selectemp <br />1 <br />G' ( <br />�j <br />( <br />` <br />`7 Oi� <br />( SCI <br />Wednesday <br />at the tlme of Injury. Sae reverse for further information. <br />Thursday <br />( Signature of Employee - <br />CLIENT <br />' We'reallze that to transfer one of Selecterrlpe employees to our <br />Friday j�Y <br />r <br />payroll requires a settlement. See Mandate. far furlheftnformadon. I <br />hereby dsrtl hat the above hours are correct.' <br />.Saturday <br />p� r' <br />Slgnatu of Supervisor <br />TOTAL' <br />TOTAL" <br />Hours to nearest quarter hour. <br />.�i .�/ <br />, <br />-' A71�W4' •�� �yZZ <br />.,- Dote <br />SELEGEMP I S unday <br />EMPL0YMENT' SERYI CES Rk_:. <br />P.O. Box 71250 • Eugene, OR 97401 Monday <br />PLEASE PRINT <br />_ + EMPLOYEE NAME <br />N rI_ <br />SOCIAL SECURITY NUMBER <br />J5 <br />COMPANY NAME <br />�. C [ L- 1C(4IL <br />WEEK.ENDING'DATE <br />❑ ASSIGNMENT COMPLETED Q RETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? <br />❑ YES IF YES, NOTIFY - SELECTEMP IMMEDIATELY. <br />'NO <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />CUSTOMER COPY <br />START <br />STOP <br />LESS <br />LUNCH <br />OVERTIME <br />HOURS <br />. l oo <br />J c a <br />FHOU <br />i7. <br />i <br />t <br />L. <br />FOR OFFICE USE ONLY <br />REG, HOURS O.T HOURS <br />EMPLOYEE <br />certty that me hours shown represent my total hours worked during the <br />weak, and that they were properly verified by the client or by an authorized <br />representative. Also, any work related injures were reported to Selectemp <br />at the time of injury Sea reverse far further Information. <br />Slgnalure of Employee <br />TOTAL TOTAL <br />Hours toneerest quarter hour. <br />CUSTOMER COPY <br />